title: Anxiety and depression disorders in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.
abstract: BACKGROUND
  The objective of this prospective study was to assess the prevalence of anxiety and depression disorders and their association with quality of life (QoL), clinical parameters and survival in patients with pulmonary hypertension (PH).
  
  
  METHODS
  We prospectively assessed 158 patients invasively diagnosed with pulmonary arterial hypertension (n = 138) and inoperable chronic thromboembolic PH (n = 20) by clinical measures including quality of life (QoL, SF-36 questionnaire), cardiopulmonary exercise testing and six minute walking distance and by questionnaires for depression (PHQ-9) and anxiety (GAD-7). According to the results of the clinical examination and the questionnaires for mental disorders (MD) patients were classified into two groups, 1) with moderate to severe MD (n = 36, 22,8%), and 2) with mild or no MD (n = 122). Patients were followed for a median of 2.7 years. Investigators of QoL, SF-36 were blinded to the clinical data.
  
  
  RESULTS
  At baseline the 2 groups did not differ in their severity of PH or exercise capacity. Patients with moderate to severe MD (group 1) had a significantly lower QoL shown in all subscales of SF-36 (p < 0.002). QoL impairment significantly correlated with the severity of depression (p < 0.001) and anxiety (p < 0.05). During follow-up period 32 patients died and 3 were lost to follow-up. There was no significant difference between groups regarding survival. Only 8% of the patients with MD received psychopharmacological treatment.
  
  
  CONCLUSIONS
  Anxiety and depression were frequently diagnosed in our patients and significantly correlated with quality of life, but not with long term survival. Further prospective studies are needed to confirm the results.
authors.affiliation: Centre for Pulmonary Hypertension, Thoraxclinic University Hospital Heidelberg, Amalienstrasse 5, Heidelberg D-69126, Germany. ekkehard.gruenig@thoraxklinik-heidelberg.de.
authors.forename: Dominik
authors.initials: D
authors.lastname: Harzheim
authors.forename: Hans
authors.initials: H
authors.lastname: Klose
authors.forename: Fabiola Peña
authors.initials: FP
authors.lastname: Pinado
authors.forename: Nicola
authors.initials: N
authors.lastname: Ehlken
authors.forename: Christian
authors.initials: C
authors.lastname: Nagel
authors.forename: Christine
authors.initials: C
authors.lastname: Fischer
authors.forename: Ardeschir
authors.initials: A
authors.lastname: Ghofrani
authors.forename: Stephan
authors.initials: S
authors.lastname: Rosenkranz
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Seyfarth
authors.forename: Michael
authors.initials: M
authors.lastname: Halank
authors.forename: Eckhard
authors.initials: E
authors.lastname: Mayer
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Grünig
authors.forename: Stefan
authors.initials: S
authors.lastname: Guth
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology* / Q000401:mortality; D003863:Depression / Q000453:epidemiology* / Q000401:mortality; D017079:Exercise Tolerance; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000401:mortality / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000150:complications / Q000401:mortality / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D015996:Survival Rate